The philosophy of kaizen is one of Toyota's core values. It means ‘continuous improvement‘. No process can ever be declared perfect but it can always be improved.

Kaizen in practice means that all team members in all parts of the organisation are continuously looking for ways to improve operations, and people at every level in the company support this process of improvement.

Kaizen also requires the setting of clear objectives and targets. It is very much a matter of positive attitude, with the focus on what should be done rather than what can be done.

Many organizations, including those in healthcare, have a stated goal of having a “culture of continuous improvement.” Many, however, fall short of that goal. The reality doesn't line up with the vision. They're far from perfect… which is understandable, as long as they are working on closing that gap between vision and reality.

Delayed Perfection

What does Twain mean by “delayed perfection?” I see and hear about behavior that illustrates this idea in hospitals all the time.

A team will sit and talk about an idea and possible solutions (instead of going to the gemba or workplace to see the problem and situation first hand). But that's a different topic.

The team might talk and talk… meet and meet… without taking action.

There's either an “analysis paralysis” or a “fear of failure” or something that gets in the way of action.

Being a perfectionist is sometimes our biggest barrier to perfection, if we're not willing to try new things… realizing that some of those new things won't work out well… short-term failures, but learning opportunities that we can learn from.

Let's say a team is working on the problem of hand hygiene compliance. As I discuss in Lean Hospitals, there's never just one root cause to a complex problem like this. Therefore, there's no single countermeasure that will “solve” the problem.

See this causal analysis that I coached a hospital through once, asking why hand hygiene practices were not followed 100% of the time (click on the image for a larger view).

A group might look and think that's discouraging… so many causes to address.

But, a culture of continuous improvement would see the potential here. Brainstorming and testing various countermeasures might close the gap a little bit. There's no magic bullet solution that takes us to perfection.

We have to keep working at it. That's Kaizen. That's continuous improvement.

The NICU at Franciscan St. Francis has seen patient / family satisfaction scores “increased from the 45th percentile to the 99th” percentile. They achieved this through hundreds of Kaizen improvements over time.

Are they perfect? Of course not. Neither is Toyota. But those organizations that keep working toward perfection… while accepting they'll never be perfect… those are the organizations that are going to be more successful in the long run.